腹部创伤感染并发症的预防

感染并发症是腹部创伤患者后期主要死因，感染预防是提高生存率的关键之一。措施包括：早期诊断腹部创伤，及时手术以减少腹腔污染；手术操作规范化和按器官损伤分级正确选择手术方式；避免术中漏诊并对胃肠严重挫伤做预防性手术；彻底冲洗腹腔并合理使用腹腔引流；正确掌握损害控制外科技术如腹腔开放时的暂时重建屏障，填塞物的适时移除和尽早行确定性手术；全身和局部预防性抗生素的使用。同时重视预防休克后肠道内源性感染，要点包括正确实施“损害控制性复苏”以避免器官长时低灌流；尽早肠内营养；预防性使用抗生素。

Prevention of posttraumatic intra-abdominal infections

Posttraumatic intra-abdominal infections are the main cause for abdominal trauma patients mor-tality at late stage.Prevention of these complications is the key to increase the survival .The measures are as fol-lows：conducting early diagnosis and timely surgical intervention to shorten intra -abdominal contamination;standardi-zing surgical technique and appropriately selecting surgical procedure according to the classification of organ injury ;avoiding miss-diagnosis and performing preventive surgical procedure for severe gastrointestinal contusion during ini -tial laparotomy;thoroughly irrigating abdominal cavity;reasonably using drainage;correctly performing damage con-trol surgeries including temporary reconstruction while open abdomen being done ,removal of packing and timely per-formance of definitive procedure;and applying prophylactic systemic and topical antimicrobials .Besides,special at-tention should be given to the gut-origin infection following hemorrhagic shock .Preventive measures include correct-ly performing damage control resuscitation to avoid prolonged hypo-perfusion of organs ,conducting early enteral nu-trition and applying prophylactic antimicrobials .